COPING WITH MYASTHENIA-GRAVIS AND IMPLICATIONS FOR PSYCHOTHERAPY

The aim of this study was to investigate psychosocial influences and m echanisms of coping to establish indications for psychotherapy in pati ents with myasthenia gravis. We investigated clinical symptoms, person ality, psychopathology, and coping in 44 patients with myasthenia grav is. The patients' personalities were not characteristically altered, a nd in 29.5% (13/44) of them, preexistent, long-term psychiatric distur bances (according to International Classification of Diseases criteria ) were present, which corresponds to the prevalence in the average pop ulation. In general, coping was characterized by an attitude of calmne ss and acceptance, which is attributable to effective medical treatmen t and could be considered an unspecific mode of coping with chronic di seases of moderate severity. Four women had undergone psychotherapy be cause of neurotic symptoms that were unrelated to myasthenia gravis. A t the end of psychotherapy, their myasthenic symptoms had greatly impr oved or disappeared. Psychotherapeutic techniques may be helpful in pa tients with neurotic or reactive psychiatric symptoms, but there is no general implication for psychotherapy in myasthenic patients, especia lly if there is adequate ''somatic'' therapy.